SPINE PROCEDURES

 Anterior Cervical Discectomy and Fusion

The vertebrae are the bones that make up the spinal column, which surrounds and protects the spinal cord. The intervertebral discs are soft tissues that sit between each vertebra and act as cushions between vertebrae, and absorb energy while the spinal column flexes, extends, and twists. Nerves from the spinal cord exit the spinal column between each vertebra.

Spinal fusion is a surgical technique in which one or more vertebrae are fused together to stop the motion between them.

Spinal fusion may be recommended for:

  • Abnormal curvature of the spine (scoliosis or kyphosis)
  • Injury to the spinal vertebrae (spine trauma)
  • Protrusion of the cushioning disc between vertebrae (slipped disc, herniated disc)
  • Weak or unstable spine caused by infections or tumors

Different incisions are made depending on the area to be treated. The approach can be made either from the front (anterior), from the back (posterior), or both. Bone grafts may be used in the area of the spine to be fused. Fusion of new bone takes about three months and continues to gain strength over the next one to two years. Until then, the back muscles hold the graft in place.

Alternatively, small titanium or carbon cylinders (known as cages) can be used to fuse two vertebrae together. The diseased disc is removed and a cage takes its place. The cage is then filled with bone graft, stimulating new bone growth that then fuses the vertebrae. Lastly, screws are sometimes used in a fusion surgery to add extra support and strength to that particular part of the vertebral column as the fusion heals. A rod is used to connect the screws which prevents movement and allows the bone graft to heal. After the fusion is completely healed, the screws and rods are typically left in place unless they cause the patient discomfort.

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 Cervical Arthroplasty (Artificial Cervical Disc)

Cervical arthroplasty refers to a surgery done to treat cervical degenerative disc disease. Some people, especially older patients, experience damage of their vertebral discs, the jelly like substance that cushions the vertebral bodies against each other. Degenerative disc disease can cause pain, numbness or weakness by compressing nearby nerves. The severity of these symptoms can range from mild to debilitating.

As with most other spinal conditions, your doctor will first try non-invasive therapeutic measures such as physical therapy, bracing, and pain medications. If these options fail to provide satisfactory relief of symptoms, you may be referred to a neurosurgeon to explore surgical options.

Artificial Cervical Discs are designed to replace the diseased disc, restore the height of the space between the vertebrae, alleviate the symptoms (pain, weakness), and preserve motion of the affected spinal column portion. This procedure is only recommended for patients who have a single vertebral disc affected and have not had prior spinal fusion surgery.  

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 Cervical Laminectomy and Fusion

Laminectomy is a surgical procedure that removes the lamina, the back portion of the vertebral body that covers the spinal cord. Removal of this piece gives the spinal canal more room and relieves the pressure from the spinal cord and nerves. The hole through which the nerve passes can be enlarged to further relieve pressure. Sometimes, a piece of bone (bone graft), metal cage, or screws may be used to strengthen the area that was decompressed. Laminectomy is usually recommended for patients who have not received much relief from conservative treatments like medications or physical therapy or for patients who have severe symptoms from nerve compression.

Patients usually require physical therapy to optimize spinal mobility after spine surgery. Results are variable depending on the disease treated.

 Foraminotomy

Foraminotomy is a procedure done to relieve pressure on nerves passing through a small opening (foramen) between vertebrae (the chain of bones that make up the spinal column). The nerves passing through these openings are branching off the spinal cord. The foramen (openings) can become compressed by bone overgrowth, scar tissue of excessive ligament growth. A foraminotomy enlarges the opening and allows more space for these nerve branches to pass through without compression.

Symptoms of nerve compression include: pain, numbness, and weakness. These symptoms can often be effectively alleviated by a foraminotomy. This is often done as a minimally invasive surgery with minimal scarring, faster recovery time, less blood loss and less painful recovery than traditional surgical approaches.

 Kyphoplasty

Kyphoplasty is a newer surgical modality used to treat pain caused by vertebral fractures and reduce the "hunching" caused by some fractures. The procedure involves using a small balloon in the vertebral body to create a hollow area. This pocket is then filled with bone cement. Surgeons typically use intraoperative imaging, such as x-rays, to help guide the cement into the target bone. Many patients will actually regain some lost height as well as enjoy pain relief after this relatively simple procedure.

 Laminoplasty/Laminectomy

Lumbar (lower back) spine disease is usually caused by herniated intervertebral discs, abnormal growth of bony processes on the vertebral bodies (osteophytes), which compress spinal nerves, trauma, and narrowing (stenosis) of the spinal column around the spinal cord.

Symptoms of lumbar spine problems include:

  • pain that extends (radiates) from the back to the buttocks or back of thigh (sciatica)
  • pain that interferes with daily activities
  • weakness of legs or feet
  • numbness of legs, feet, or toes
  • loss of bowel of bladder control

Laminectomy is a surgical procedure that removes the lamina, the back portion of the vertebral body that covers the spinal cord. Removal of this piece gives the spinal canal more room and relieves the pressure from the spinal cord and nerves. The hole through which the nerve passes can be enlarged to further relieve pressure. Sometimes, a piece of bone (bone graft), metal cage, or screws may be used to strengthen the area that was decompressed. Laminectomy is usually recommended for patients who have not received much relief from conservative treatments like medications or physical therapy or for patients who have severe symptoms from nerve compression.

Patients usually require physical therapy to optimize spinal mobility after lumbar spine surgery. Results are variable depending on the disease treated.

 Lumbar Fusion

The vertebrae are the bones that make up the spinal column, which surrounds and protects the spinal cord. The intervertebral discs are soft tissues that sit between each vertebra and act as cushions between vertebrae, and absorb energy while the spinal column flexes, extends, and twists. Nerves from the spinal cord exit the spinal column between each vertebra.

Spinal fusion is a surgical technique in which one or more vertebrae are fused together to stop the motion between them.

Spinal fusion may be recommended for:

  • Abnormal curvature of the spine (scoliosis or kyphosis)
  • Injury to the spinal vertebrae (spinal trauma)
  • Protrusion of the cushioning disc between vertebrae (slipped disc, herniated disc)
  • Weak or unstable spine caused by infections or tumors

Different incisions are made depending on the area to be treated. The approach can be made either from the front (anterior), from the back (posterior), or both. Bone grafts may be used in the area of the spine to be fused. Fusion of new bone takes about three months and continues to gain strength over the next one to two years. Until then, the back muscles hold the graft in place.

Alternatively, small titanium or carbon cylinders (known as cages) can be used to fuse two vertebrae together. The diseased disc is removed and a cage takes its place. The cage is then filled with bone graft, stimulating new bone growth that then fuses the vertebrae. Lastly, screws are sometimes used in a fusion surgery to add extra support and strength to that particular part of the vertebral column as the fusion heals. A rod is used to connect the screws which prevents movement and allows the bone graft to heal. After the fusion is completely healed, the screws and rods are typically left in place unless they cause the patient discomfort.

 Minimally Invasive Lumbar Laminectomy

Laminectomy is a surgical procedure that removes the lamina, the back portion of the vertebral body that covers the spinal cord. With a minimally invasive approach, the surgeon uses cutting edge technology to minimize disruption of normal anatomy while reaching the targeted lumbar vertebrae. Removal of the lamina through small incisions gives the spinal canal more room and relieves the pressure from the spinal cord and nerves. The hole through which the nerve passes can be enlarged to further relieve pressure. Sometimes, a piece of bone (bone graft), metal cage, or screws may be used to strengthen the area that was decompressed. Laminectomy is usually recommended for patients who have not received much relief from conservative treatments like medications or physical therapy or for patients who have severe symptoms from nerve compression.

The minimally invasive approach generally means shorter recovery periods, smaller incisions and faster healing. Most patients still require physical therapy to optimize spinal mobility after spine surgery. Results are variable depending on the disease treated.

 Minimally Invasive Lumbar Microdiscectomy

Discectomy is the removal of the damaged parts of a herniated disc. A herniated disc can cause pain, numbness or weakness by compressing nearby nerves. Often times, patients also experience pain that radiates down the arm or leg. In these cases, microdiscectomy can provide good relief from symptoms. Discectomies can be performed either via traditional incisions or via small incisions and the use of a microscope for faster healing time, less pain and smaller scars. The portion of damaged disc removed may be replaced by a bone graft. Your surgeon will then fuse the adjacent vertebrae together with metal hardware to keep the spinal column stable.

 Minimally Invasive Spine Surgery

Minimally Invasive Spine Surgery describes the new approaches developed to treat spinal conditions with minimal disruption to a person's anatomy. With cutting-edge technology and precision, surgeons are able to help patients achieve relief with shorter recovery times, smaller scars, less blood loss and less post-operative pain. These techniques have been tried, tested and proven effective.

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 Occipital Cervical Fusion

The occiput is the back portion of the skull that sits at the top of the neck. The cervical spine is the segment of vertebrae that runs through the neck. Occipital-Cervical fusion stabilizes the juncture between these two segments. This procedure is necessary for certain congenital anomalies, spontaneous dislocations or destabilizing traumatic injuries to the joint between the top of the cervical spine and the base of the skull. The goal of this fusion is to prevent an unstable joint from leading to injury to the spinal cord or the critical brain structures at the skull base.

Bone grafts and/or screws may be used in the area of the spine to be fused. Fusion of new bone takes about three months and continues to gain strength over the next one to two years. Until then, the neck muscles hold the graft in place. After the fusion is completely healed, the screws are typically left in place unless they cause the patient discomfort.

 Odontoid Screw Placement

The odontoid process is a segment of the second cervical vertebra. This portion of the bone helps join the skull base with the rest of the cervical vertebrae. Sometimes, this process can be fractured by a traumatic injury. In the elderly, a simple slip can lead to an odontoid fracture.

Depending on the position of the fracture, the patient may need to have the bone stabilized surgically. In these cases, a surgeon will place a screw through the fractured process to stabilize it and prevent injury to the spinal cord. This is a very delicate procedure that is often done with the assistance of radiographs to guide the screw placement into the precise position desired.

 Spinal Laminectomy for Spinal Tumors

Laminectomy is a surgical procedure that removes the lamina, the back portion of the vertebral body that covers the spinal cord. For patients with spinal tumors, this surgery is sometimes necessary if the tumor has compromised the spinal canal. Removal of this piece gives the spinal canal more room and relieves the pressure from the spinal cord and nerves. The hole through which the nerve passes can be enlarged to further relieve pressure. Sometimes, a piece of bone (bone graft), metal cage, or screws may be used to strengthen the area that was decompressed. Laminectomy is usually recommended for patients who have not received much relief from conservative treatments like medications or physical therapy or for patients who have severe symptoms from nerve compression.

Patients usually require physical therapy to optimize spinal mobility after spine surgery. Results are variable depending on the disease treated.